Provider Demographics
NPI:1013573831
Name:ARNOLD, BRIGITTA JACKSON (MS, LPC, MHC, CMFT)
Entity Type:Individual
Prefix:
First Name:BRIGITTA
Middle Name:JACKSON
Last Name:ARNOLD
Suffix:
Gender:F
Credentials:MS, LPC, MHC, CMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:203 MISTY HILL TRL
Mailing Address - Street 2:
Mailing Address - City:DALLAS
Mailing Address - State:GA
Mailing Address - Zip Code:30132-1197
Mailing Address - Country:US
Mailing Address - Phone:404-234-2955
Mailing Address - Fax:
Practice Address - Street 1:8335 OFFICE PARK DR
Practice Address - Street 2:
Practice Address - City:DOUGLASVILLE
Practice Address - State:GA
Practice Address - Zip Code:30134-6937
Practice Address - Country:US
Practice Address - Phone:678-324-0476
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-05-16
Last Update Date:2019-05-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GALPC010895101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health